University of Cebu – Banilad

College of Nursing
Cebu City

SKILLS LABORATORY PERFORMANCE CHECKLIST

NEBULIZATION

Name: Inting, Katriona Reine C. Year & Section: 3 - E Grade:

LEGEND:
EQUIPMENT: 1 - Excellent
Nebulizer 2 – Very Satisfactory
Drug ordered (ex. Terbutaline sulfate (ventolin) nebule ) 3 – Satisfactory
Mouth piece or oxygen mask 4 –Needs Improvement
Tubing or nebulizer cap 5 – Poor

E VS S NI P
PROCEDURE RATIONALE
1 2 3 4 5
1. Gather all equipment. To save time, energy and
unnecessary trips back and
forth.
2. Place the medication and NNS in nebulizer cap. To ensure efficacy of procedure
prior to the treatment of patient.
3. Attach tubing to the connector. To be able to access oxygen for
the procedure.
4. Assess the best position for patient.
a. Place patient on side of bed in sitting Inhalation of nebulized
position with feet on the floor. medications is best performed
b. Have patient sit on chair. in upright sitting to maximize
c. Side lying position. lung volumes.
5. Instruct patient on the following:
a. mouthpiece Placing the mouthpiece tight
- keep lips tightly around the mouthpiece around the patient’s lips ensures
- breath only through mouth all of the medicine goes into the
- let patient have a “clearing breath” (after every patient’s lungs. Breathing
5-7 breaths, remove mouthpiece from mouth through mouth makes sure the
and hold breath for at least 5 sec. (10 sec. in medicine can go deep into the
better) then exhale slowly. lungs.
b. If aerosol mask is used, place the mask over
the mouth and nose, then inhale deeply and
slowly through the mouth; then exhale slowly. Aerosol mask is used to
facilitate administration of
nebulized therapy to patients
who are unable to use a
mouthpiece.

6. Continue treatment until nebulizer is empty To make sure the prescribed

usually about 20 minutes. amount of medication is being
used for efficacy.
7. Record.
- medication Good documentation is a
- date nurse’s responsibility and it
- time promotes patient safety and
quality care.

COMMENTS:

Clinical Instructor’s Signature

Date